This study investigated patients who underwent bilateral hypogastric artery ligation (BHAL) due to postpartum haemorrhage (PPH). Patients who underwent BHAL because of PPH following a conservative treatment were included in this study. Placental abnormalities were referred to as placenta accreta. A total of 130 BHAL procedures took place at the study hospital as a result of PPH. Of these, 39 (30%) were referred to the hospital. The rate of BHAL requirement was 62 out of 10,000 births. Among the 130 patients, the most frequent indication for BHAL was placenta accreta (58.5%). Haematological parameters were poorer among the referral patients. Four of the exitus patients (80%) were referral patients. The mortality rate among the referral patients was 10.25%, whereas this rate was only 1.01% among the patients who gave birth at the hospital. PPH is a life-threatening condition that requires immediate medical attention. BHAL, with its fertility-preserving features, is a good option that can be employed in all PPH patients. BHAL not only preserves patients’ fertility, but it also gives them a higher chance of survival.
Objective: To investigate the levels of anti-angiogenic factors, namely sFlt-1 and Netrin-4, in patients with preeclampsia (PE). Material and methods: Cord-blood (UC) sFlt-1 and Netrin-4 concentrations were measured in 30 patients with severe PE, 30 patients with PE and 30 control infants and their mothers (MS). Results: Maternal sFlt-1 levels were significantly higher in the severe PE and PE groups than in the control group. There were no statistical differences among the three groups in maternal and fetal Netrin-4 levels. But Netrin-4 levels were found to be the lowest in the control group and higher in the PE and severe PE groups. The correlation analysis revealed a positive correlation between maternal sFlt-1 levels and maternal Netrin-4 levels (p = 0.012, and r = 0.263), maternal sFlt-1 levels and fetal sFlt-1 levels (p = 0.012, and r = 0.263). Conclusions: There was a positive correlation found between maternal sFlt-1 levels and maternal Netrin-4 levels. We are of the opinion that elevation in levels of Netrin-4 might be secondary to placental hypoxia occurring in PE. The present study led to the consideration of anti-angiogenic biomarkers (sFlt-1 and Netrin-4) on automated platforms for clinical use as an aid in establishing the diagnosis and prognosis of PE. Objective: To investigate the levels of anti-angiogenic factors, namely sFlt-1 and Netrin-4, in patients with preeclampsia (PE). Material and methods: Cord-blood (UC) sFlt-1 and Netrin-4 concentrations were measured in 30 patients with severe PE, 30 patients with PE and 30 control infants and their mothers (MS). Results: Maternal sFlt-1 levels were significantly higher in the severe PE and PE groups than in the control group. There were no statistical differences among the three groups in maternal and fetal Netrin-4 levels. But Netrin-4 levels were found to be the lowest in the control group and higher in the PE and severe PE groups. The correlation analysis revealed a positive correlation between maternal sFlt-1 levels and maternal Netrin-4 levels (p = 0.012, and r = 0.263), maternal sFlt-1 levels and fetal sFlt-1 levels (p = 0.012, and r = 0.263). Conclusions: There was a positive correlation found between maternal sFlt-1 levels and maternal Netrin-4 levels. We are of the opinion that elevation in levels of Netrin-4 might be secondary to placental hypoxia occurring in PE. The present study led to the consideration of anti-angiogenic biomarkers (sFlt-1 and Netrin-4) on automated platforms for clinical use as an aid in establishing the diagnosis and prognosis of PE.
1 January 2023 in Revista da Associação Médica Brasileira
This study aimed to investigate the expression levels of sirtuin 2 and sirtuin 7 in the placenta accreta spectrum to reveal their role in its pathogenesis.
1 January 2024 in Revista da Associação Médica Brasileira
Placenta accreta spectrum (PAS) is defined as the attachment of the placenta to the uterine wall in varying degrees. However, the studies have explored that the underlying molecular mechanisms of the PAS are very limited. Sirtuins 1 (SIRT1) is associated with placental development by controlling trophoblast cell invasion and remodeling of spiral arteries. We aimed to determine the expression level of SIRT1 in placentas, and maternal and umbilical cord serum of patients with PAS.
Around 70 percent of cases of Primary Ovarian Insufficiency (POI) etiology remain unexplained. The aim of our study is to contribute to the etiology and genetic background of POI. A total of 37 POI patients and 30 women in the reproductive period were included in this prospective, case-control study between August 2020 and December 2021. The women were examined for 36 genes with next-generation sequencing (NGS) panel. Gene variations were detected in 59.5 percent of the patients in the case group. FSHR p.S680N (rs6166, c.2039 G>A) and FSHR p.A307T (rs6165, c.919 G>A) gene variants, which are most frequently located in exon 10 of the FSHR gene, were detected in both groups. Although it was not found that these gene variants were significantly different between the groups, it was also found that they were significantly different in POI patients under 30 years of age and in those with a family history of POI. Variations were detected in 12 genes in POI patients. Two gene variants (FGFR1 [c.386A>C, rs765615419] and KISS1 [c.58 G>A, rs12998]) were detected in both groups, and the remaining gene variants were detected only in POI patients. No differences were detected between the groups in terms of gene variations. However, the gene variations detected only in POI patients may play a role in the etiology of POI.